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Inflammatory Bowel Disease in Pregnancy

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Inflammatory Bowel Disease in Pregnancy, Crohn's Disease in Pregnancy, Ulcerative Colitis in Pregnancy

  • Risks for Pregnancy
  1. Non-active Inflammatory Bowel does not affect pregnancy
  2. Risks of uncontrolled active Inflammatory Bowel Disease
    1. Miscarriage
    2. Premature labor and preterm delivery
    3. Intrauterine Growth Retardation
  • Evaluation
  1. Avoid endoscopy in pregnancy due to Preterm Labor risk
  2. Avoid radiographic imaging in pregnancy
  • Management
  1. Recommended in Active Inflammatory Bowel
    1. Sulfasalazine
      1. Potential risk of Kernicterus in newborns
      2. Avoid near term if possible
    2. Corticosteroids
    3. Mesalamine (5-ASA)
  2. Agents to use with caution in refractory disease
    1. Azathioprine
    2. Mercaptopurine
  3. Agents to avoid in pregnancy
    1. Immunosuppressants
    2. Methotrexate